Abstract
BACKGROUND: The incidence of mortality after treat-ment of unruptured intracranial aneurysms (UIAs) has been described historically. However, many advances in micro-surgical treatment have since emerged, and most available data are outdated. We analyzed the incidence of mortality after microsurgical treatment of patients with UIAs treated in the past decade.METHODS: The medical records of all patients with UIAs who underwent elective treatment at our large qua-ternary center from January 1, 2014, to December 31, 2020, were reviewed retrospectively. We analyzed mortality at discharge and 1-year follow-up as the primary outcome using univariate to multivariable progression with P < 0.20 inclusion.RESULTS: During the 7-year study period, 488 patients (mean [SD] age [ 58 [12] years) had UIAs treated micro-surgically. Of these patients, 61 (12.5%) had a prior sub-arachnoid hemorrhage. One patient (0.2%) with a dolichoectatic vertebrobasilar aneurysm died while hos-pitalized, and 7 other patients (8 total; 1.6%) were deter-mined to have died at 1-year follow-up (1 trauma, 2 myocardial infarction, 2 cerebrovascular accident, 1 pul-monary embolism, and 1 subdural hematoma complicated by abscess). On univariate analysis, significant risk factors for mortality at follow-up included diabetes mellitus, pre-operative anticoagulant or antiplatelet use, aneurysm calcification, nonsaccular aneurysm, and higher American Society of Anesthesiologists grades (all P < 0.03). On multivariable logistic regression analysis, only non-saccular aneurysms and higher American Society of An-esthesiologists grades were predictors of mortality.CONCLUSIONS: A low mortality rate is associated with recent microsurgical treatment of UIAs. However, non-saccular aneurysms and higher American Society of An-esthesiologists grades appear to be predictors of mortality.